‘A practice-changing trial’: Semaglutide linked to key benefits for PAD patients with diabetes
Semaglutide, the GLP-1 receptor agonist sold by Novo Nordisk under the brand names Wegovy and Ozempic, is associated with significant health benefits for patients with type 2 diabetes and peripheral artery disease (PAD), according to a late-breaking clinical trial presented at ACC.25, the annual meeting of the American College of Cardiology (ACC).
As he presented his team’s data, lead author Marc P. Bonaca, MD, a cardiologist with the University of Colorado School of Medicine, noted that PAD is often the first manifestation of cardiovascular disease in patients with diabetes. Patients who present with both diabetes and PAD can be especially challenging to treat, he added, and the available treatment options are limited.
Because GLP-1 receptor agonists have already been linked to a long list of health benefits, including several associated with improvements in cardiovascular symptoms, Bonaca et al. thought semaglutide could potentially provide relief for these high-risk patients.
The STRIDE clinical trial, funded by Novo Nordisk, included data from nearly 800 adult patients enrolled at 112 medical centers throughout North America, Asia and Europe. All patients presented with both type 2 diabetes and PAD with intermittent claudication. These were severely disabled patients, Bonaca explained, and a majority reported that they regular encountered prominent limitations when trying to walk.
Patients were randomized to receive once-weekly doses of subcutaneous semaglutide or a placebo for 52 weeks. The median age for both the semaglutide group and the placebo group was 68 years old. In addition, the majority of patients in both groups were white and male.
Overall, researchers found that semaglutide was associated with significant improvements in maximum walking distance—a statistic measured by putting participants on a treadmill at a moderate incline—after one year of treatment compared to a placebo. In fact, the average improvement in maximum walking distance was 40 meters for patients given semaglutide, and this was a benefit seen regardless of a patient’s age, sex or body mass index.
In addition, Bonaca explained during his presentation, semaglutide was associated with improvements in a variety of secondary endpoints, including pain-free walking distance and sustained improvement in maximal walking distance five weeks after stopping the drug, compared to a placebo.
“Semaglutide is the first drug in PAD and type 2 diabetes to reduce major adverse cardiovascular events, improve cardiometabolic and kidney outcomes and improve walking capacity symptoms and related quality-of-life outcomes in this difficult-to-treat population,” Bonaca said. “We have a new drug for PAD.”
These STRIDE findings were simultaneously published in The Lancet.[1] Click here to read the team’s full analysis.
Clinicians impressed with STRIDE findings
The ACC.25 panelists on hand when Bonaca made his presentation were all clearly excited about these findings.
“It is an amazing thing when people focus on the fundamental missions of our work, which are to make people feel better and live longer,” said Josha Beckman, MD, chief of vascular medicine with UT Southwestern Medical Center in Dallas, as he congratulated Bonaca.
Beckman also highlighted the impressive nature of these improvements in walking distance.
“I don’t think everybody really understands how much what we describe as mild claudication limits patients,” he said. “When you do physical component scores, they feel as poorly as patients with New York Heart Association class III heart failure. Only being able to walk 100 meters is a horrendous result, and any improvement is an important one.”
Beckman added that these improvements will be “easily noticeable” to the patients who live with these symptoms day in and day out
“Forty meters doesn’t sound like a lot, but I am telling you: it is a lot,” he said.
Kim Eagle, MD, director of the Frankel Cardiovascular Center at University of Michigan Health, was another panelist when these findings were presented. He described STRIDE as a “practice-changing trial” and cheered the long-term impact semaglutide could have on the lifestyles of these patients.
Good news for Novo Nordisk
Novo Nordisk, which funded STRIDE, issued an immediate statement celebrating these positive findings.
“By studying the potential of semaglutide to impact everyday living through improvements in walking and quality of life, Novo Nordisk continues to demonstrate its commitment to advancing cardiometabolic science and to improving clinical outcomes for patients,” said Michael Radin, MD, Novo Nordisk’s executive medical director of diabetes medical affairs.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.